Short KYB Form B2B

First Name

Middle Name

Last Name

Email

Phone

Social Security Number

Date of Birth

Month

Day

Year

Photo ID or Passport (Front)

Photo ID or Passport (Back)

Section 2: Company Information

Company Name

Company Type

Enter the legal structure of your company (e.g., LLC, Corporation, or similar).

EIN

Registered Address

Enter your company’s full registered business address.

How long has the company been in operation?

Formation Documents

Please upload the company’s formation documents, such as its Articles of Incorporation or Articles of Organization.

Proof of Address

Please upload a recent document verifying the company’s registered address, such as a bank statement or utility bill dated within the last three months.

Company Owners

Please provide the following information for each owner of the company: full name, address, date of birth, and percentage of ownership.

Does the company hold all permissions, registrations, and licenses required by law to conduct its business activities?

Yes

No

Has any owner, board member, senior management, shareholder, or the company itself ever been involved in a criminal investigation or administrative proceeding?

Yes

No

If yes, please provide details.

I confirm that none of the company’s owners, board members, senior management, or shareholders are Politically Exposed Persons (PEPs) or Sanctioned Persons, and that none are family members or close associates of any PEP or Sanctioned Person.

Section 3: Financial Information

Bank Name

Bank Account Holder's Name

Bank Address

Bank Account Number

ABA Routing Number

Wire Routing Number

IBAN (International Bank Account Number)

SWIFT/BIC Code

Bank Statement

Please upload a bank statement from the bank listed above, dated within the last three months.

Form W-9 (or W-8BEN)

Please fill out and upload your form W-9 which you can download here: https://www.irs.gov/pub/irs-pdf/fw9.pdfIf you're not a U.S. citizen, please fill out and upload your form W-8BEN which you can download here: https://www.irs.gov/pub/irs-pdf/fw8ben.pdf

Does the company have any outstanding debt obligations, liens on its receivables, unpaid tax invoices or debts, or has it ever been subject to any restrictions or fines imposed by regulatory, tax, or other authorities?

Yes

No

If yes, please provide details below.

Section 4: Legal Information

Are there any pending or recent legal disputes or claims involving the company?

Yes

No

If yes, please provide details below.

I consent to a background check.

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